Scalp Reductions - The Not-so-good, The Bad, And the Very Ugly

The goal of scalp reduction surgery is to minimize the balding area by surgically reducing the bare scalp. Portions of the bald scalp on the top of the head are removed and the hair-bearing areas at the side of the head are pulled together at the crown.

This is an older method of hair restoration and the vast majority of surgeons no longer perform this procedure since new technological advances have made hair restoration easier and less painful.

Below is an overview of the scalp reduction procedure:

- The patient is given a local anesthetic.

- A segment of the bald scalp is removed. It is usually cut into an inverted Y-shape, a U-shape, or a pointed oval pattern.

- The skin surrounding the scalp area that has been removed is loosened and pulled upwards. This allows the hair-bearing parts of the scalp to be sutured together towards the crown of the head. This part of the procedure is reported as being uncomfortable and painful.

Candidacy for a scalp reduction depends on the flexibility of the scalp, the amount of hair loss and the patient’s age.

Below are some of the major reasons why scalp reduction surgery has decreased in popularity since the introduction of more advanced methods of hair restoration:

• There is a risk that the skin might stretch back to 50% of its original positioning


• A visible scar is left on the exposed areas of the bald scalp


• An indentation surrounding the scar line may be noticeable


• The hair may acquire an unusual parting that cannot be grafted


• If the scalp is reduced in an elliptical pattern, it will result in an esthetically unpleasant elongation of the bald area